The bill amends section 3902.50 of the Revised Code and enacts a new section, 3902.80, to establish regulations regarding the use of artificial intelligence (AI) by health insurers in Ohio. It updates the definition of the sections covered by the law, replacing the previous reference to section 3902.72 with the new section 3902.80. The new section outlines specific requirements for health plan issuers, including the obligation to file an annual report with the superintendent of insurance detailing their use of AI in utilization review processes. This report must include information about the algorithms used, the data sets for training, and the outcomes of the AI applications.

Additionally, the bill prohibits health plan issuers from making decisions about a covered person's care based solely on AI-derived results regarding medical necessity. It mandates that such determinations must involve a licensed physician or qualified provider who considers the individual circumstances and recommendations of the requesting provider. Furthermore, any decision influenced by AI must be accompanied by a clear explanation of the rationale behind it. The superintendent of insurance is granted the authority to audit the use of AI by health plan issuers and may engage third parties for this purpose. The provisions of this new section apply to health benefit plans issued, amended, or renewed after the effective date of the legislation.

Statutes affected:
As Introduced: 3902.50